1. Page 1

 
COMPLETE THIS
SECTION
ON DELIVERY
A. Sprat
1/2/en
eentAddressee
typ
eiveg(
Printed Name)
Q.
I 6
Date
?
of Delivery
r
?
[
RECEIVED
CLERKS OFFICE
JUN 1 6 2008
STATE OF ILLINOIS
Pollution Control Board
SENDER:
COMPLETE THIS SECTION
Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
Print your name and address on the reverse
so that we can return the card to you.
Attach this card to the back of the mailpiece,
or on the front If space permits.
1 Article Addressed to:
?
6/5/08
?
jt
PCB 2007-134
Gregory E. Cox
Nicolosi & Associates, LIZ
363 Financial Court, Suite 100
Rockford,
?
61107-6671
D. Is delivery address different from Item 1?
0
Yes
If YES, enter delivery address below:
?
0
No
3. Service Type
0
Certified Mail
0
Express Mail
0 Registered
?
0
Return Receipt for Merchandise
0 Insured Mail
?
13
C.O.D.
4. Restricted Delivery?
(Extra Fee)
?
0
Yes
2. Article
(Transfer
Number
from service label)
7007-3020 0000
4630 6538
PS
Form 3811,
February 2004
Domestic Retum Receipt
10259502-M-1q40
ru U-111.3 la J13?
C
SENDER:
COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
Print your name and address on the reverse
so that we can return the card to you.
Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
?
6/5/08 jt
PCB 2007-134,
Dale Adams
Village of iockton
110 East Main Street
Rockton, IL 61072
A.
Signature
X?
0
Agent
q
Addressee
,Ived by (Printed
Name)?
C. Dat of D livery
L
iaz/vOekcep.-4,.....
‘ /
6
oV*
D. Is delivery address different from Item 1? 0 Yes
If YES, enter delivery address below: ?
0
No
3. Service Type
0
Certified Mail 0
Express Mail
0 Registered
?
0
Return Receipt for Merchandise
0 Insured Mall
?
q
C
.O.D.
4. Restricted Delivery?
(Extra Fee)
?
0 Yes
2. Article Number
(Transfer from
service
labs°?
7007 3020 0000 4630 6521
PS Form 3811, February 2004
Domestic Return Receipt
?
102595-02-M-1540

Back to top